Texas Legislative Update

Legislative Interim Charges Highlight Key Health Policy Priorities Ahead of 90th Session

Texas legislative leaders have released interim charges for both the House and Senate, outlining priority issues for committees to study ahead of the 90th Legislative Session in January 2027. Several charges across both chambers focus on healthcare delivery, cost drivers, and regulatory issues impacting physicians and patient access.

In the Senate, the Health and Human Services Committee has already begun its interim work, holding its first hearing focused on fraud, waste, and abuse within Medicaid and other public programs. The committee is expected to continue examining cost drivers, behavioral health services, and system-wide efficiencies in the months ahead.

On the House side, the Select Committee on Health Care Affordability will hold its first interim hearing next week, with invited testimony centered on key drivers of healthcare costs and system performance. Topics include evaluating statutory, regulatory, and administrative burdens; the impact of insurance design, cost sharing, and payment policies; the effects of market consolidation on competition and patient choice; and the level of price transparency available to consumers in healthcare markets.

More broadly, interim charges across both chambers signal continued legislative focus on rising healthcare costs, administrative complexity, and access to care—including mental health services, Medicaid delivery and provider enrollment, and workforce challenges. These discussions will shape committee recommendations and inform legislation that could significantly impact physician practice and healthcare delivery in Texas.

Full list of both chamber’s charges:

• Senate Interim Charges
• House Interim Charges

Texas Primary Recap

Texas voters turned out in strong numbers for the March primary elections, with early voting exceeding levels seen in recent cycles. Final statewide turnout reached approximately 2.4 million voters, or about 13 percent of registered voters, reflecting elevated engagement across much of the state. While Republicans maintain majorities heading into the general election, Democratic turnout in several counties also outpaced prior primary benchmarks.

Most incumbents seeking re-election secured their party’s nomination, though a small number were defeated. Primary elections tend to favor candidates who appeal strongly to their party’s base, which can result in more ideologically defined nominees and set up competitive general election matchups where independent and swing voters may play a larger role.

Republicans entered the election cycle holding a 20–11 majority in the Texas Senate and an 88–62 majority in the Texas House. All 150 House seats and 16 of 31 Senate seats were on the ballot, determining nominees for the November general election.

At the statewide level, the Republican primary for U.S. Senate advanced to a May runoff between incumbent Senator John Cornyn (42%) and Attorney General Ken Paxton (41%). On the Democratic side, State Representative James Talarico secured the nomination and will face the Republican nominee in November.

The open race for Texas Comptroller—following Glenn Hegar’s resignation—also drew significant attention. Acting Comptroller Kelly Hancock currently oversees the office. Former State Senator Don Huffines won the Republican nomination, while State Senator Sarah Eckhardt secured the Democratic nomination. The office plays a critical role in tax collection, revenue forecasting, and certification of the state budget.

Legislative turnover will be a defining feature heading into the 2027 session. The Texas House is expected to add at least 24 new members due to primary losses and retirements, while the Senate will also see new members following recent elections and open seats. Early nominees to replace departing senators include Trent Ashby (SD 3), Brett Ligon (SD 4), Dennis Paul (SD 11), and David Cook (SD 22). Texas’ congressional delegation may also shift following the November election.